Endovascular repair of popliteal artery aneurysms with Anaconda limbs: technique and early results.
OBJECTIVE
The objective is to report the feasibility and technique of treating popliteal artery aneurysms (PAA) with a stent made of nitinol rings externally supported by thin polyester (Anaconda limbs).


BACKGROUND
PAA are the most common peripheral aneurysms. The main limitations of stents used in these settings are: short lengths, longitudinal and horizontal compliance mismatch; graft failure from angulation and movement at the joint level; and dislodgment.


METHODS
This is a prospective multicenter cohort study of consecutive symptomatic and asymptomatic PAA treated in tertiary vascular centers. Outcomes included patency of the stent and postoperative time-to-independent-ambulation and to-climb-a-flight-of-stairs.


RESULTS
Fourteen PAA were treated in 12 men, age 72 +/- 3 years. The median ASA classification was 2.5. The length of artery covered was 147 +/- 41 mm. The PAA diameter was 31 +/- 5 mm, 6 were symptomatic. One stent was used in 6 aneurysms, two in 7, and three in 1. The average stent diameter was 10 +/- 1 mm. The length of the proximal neck was 24 +/- 6 mm with a diameter of 9.8 +/- 1.9, and length of the distal neck 23 +/- 3 mm with a diameter of 8.7 +/- 1.2 mm. In 6 aneurysms, the stent crossed the knee joint. There was no mortality, and one stent occluded (primary patency 93% at 6 +/- 3 months). The median hospital stay was 1.7 days, time to independent ambulation was 3 hr and the time to climbing a flight of stairs was 1 day.


CONCLUSIONS
The use of Anaconda limbs for endovascular repair of PAA is feasible and safe.
Cinà
C S
CS
Division of Vascular Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. cinac@smh.toronto.on.ca
Moore
R
R
Maggisano
R
R
Kucey
D
D
Dueck
A
A
Rapanos
T
T
D000203:Activities of Daily Living; D000368:Aged; D000497:Alloys; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D005240:Feasibility Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D009864:Ontario; D010865:Pilot Projects; D011091:Polyesters; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D011474:Prosthesis Design; D020127:Recovery of Function; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency; D016138:Walking
D000497:Alloys; D011091:Polyesters; C013616:nitinol